Endoscopic snare device
The present subject matter discloses a tissue removal tool for use with an endoscope. The tool comprises a loop formed by a piece of wire and movable between an open position and a closed position, and a transmitting assembly comprising: a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop portion being movable between the open and closed position by action of the handle. The loop is defined in the open position by a proximal portion and a distal portion. The widest portion of the loop is more proximal to a proximal end of the loop than the mid-point of the length of the loop is.
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This application is a continuation of U.S. patent application Ser. No. 15/866,401, filed Jan. 9, 2018, which claims the benefit of U.S. Provisional Patent Application No. 62/444,144, filed on Jan. 9, 2017, both disclosures of which are hereby incorporated herein by reference in their entirety.
TECHNICAL FIELDThe present subject matter relates generally to endoscopic snare devices.
BACKGROUNDPolypectomy, or the removal of polyps, has become one of the most common endoscopic procedures in gastrointestinal endoscopy today. Its relative simplicity often belies the effectiveness of the procedure at preventing colorectal cancer. The National Polyp Study (NPS) demonstrated a reduction in the incidence of colorectal cancer of 76%-90% following colonoscopic polypectomy. Standard practice for polypectomy has been to use an electrocautery or “hot” snare to remove polyps due to the fact that it reduces the risk of bleeding as a result of the coagulation effect created by the current. Electrocautery, however, can create inadvertent damage to healthy tissue and may not be necessary for smaller sized polyps where bleeding risk is not a concern.
A “cold” snare, such as US Endoscopy Group Inc.'s Exacto® snare, is designed for polypectomy procedures where diminutive polyps are encountered. It enables a clean cut that reduces polyp “fly away” form the resection site. Studies comparing Exacto® snare to hot snares have shown that, for diminutive polyps in the 3-8 mm range, there is no difference in postpolypectomy bleeding and it requires less time to use than hot snares while being just as safe and effective.
SUMMARYThe present subject matter describes a tissue removal tool for use with an endoscope. The tool comprises a loop formed by a piece of wire and movable between an open position and a closed position, and a transmitting assembly comprising: a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop portion being movable between the open and closed position by action of the handle. The loop is defined in the open position by a proximal portion and a distal portion. The widest portion of the loop is more proximal to a proximal end of the loop than the mid-point of the length of the loop is.
The present subject matter further describes a tissue removal tool having a cutting section disposed along the distal portion of the loop.
The features and advantages of the general inventive concepts will become apparent from the following detailed description made with reference to the accompanying drawings.
This Detailed Description merely describes exemplary embodiments in accordance with the general inventive concepts and is not intended to limit the scope of the invention or the claims in any way. Indeed, the invention as described by the claims is broader than and unlimited by the exemplary embodiments set forth herein, and the terms used in the claims have their full ordinary meaning.
The general inventive concepts will now be described with occasional reference to the exemplary embodiments of the invention. This general inventive concept may, however, be embodied in different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the general inventive concepts to those skilled in the art.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art encompassing the general inventive concepts. The terminology set forth in this detailed description is for describing particular embodiments only and is not intended to be limiting of the general inventive concepts. As used in this detailed description and the appended claims, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise.
Unless otherwise indicated, all numbers such as, for example, numbers expressing measurements or physical characteristics, used in the specification and claims are to be understood as being modified in all instances by the term “about.” Accordingly, unless otherwise indicated, the numerical properties set forth in the specification and claims are approximations that may vary depending on the suitable properties sought to be obtained in embodiments of the invention. Notwithstanding that the numerical ranges and parameters setting forth the broad scope of the general inventive concepts are approximations, the numerical values set forth in the specific examples are reported as precisely as possible. Any numerical values, however, inherently contain certain errors necessarily resulting from error found in their respective measurements.
The present application describes a tissue removal tool for use with an endoscope, comprising: a loop formed by a piece of wire and movable between an open position and a closed position; a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop being movable between the open and closed position by action of the handle, wherein the loop is defined in the open position by a proximal portion and a distal portion.
Referring to
The tool may include a support assembly and a transmitting system for moving the loop between an open position and a closed position. In the exemplary tool 10 illustrated in
The handle allows an operator to move the loop back and forth between a deployed position, as shown in
A link 22 is connected to the handle 20 for transferring axial motion from the handle 20 to other parts of the device. The link may be constructed of any suitable rigid material, and may be solid, hollow, or any suitable elongated object or combination of objects. The link may be one piece or formed from a series of pieces and connections, such as for example, hypodermic tubes, swage connections, and cables. The link 22 has a first end fixed to the handle 20 and a second end remote from the body 16. As shown in the drawings, the link extends substantially through the conduit 18.
The proximal portion 130 of the loop 12 generally does not perform cutting but provides assistance and support to encircle and recruit tissue for cutting. Increasing the stiffness of the proximal portion allows for greater indentation of the tissue which improves tissue recruitment. The stiffer proximal portion 130 can be about the proximal ⅓ to ½ of the loop 12. The proximal portion may vary in stiffness along its length.
In an embodiment shown as
In an embodiment shown as
In an embodiment shown as
In some embodiments, such as those shown as
In an embodiment shown in
In an embodiment shown in
In an embodiment shown in
In some embodiments shown in
In an embodiment shown in
Referring now to
The distal tip 150 of the tool may have alternative shapes. US 2014/0052142 A1 and US2015/0066045 A1 disclose multiple distal loop or coil tip designs, the contents of which are incorporated herein. The wire may form a torsion tip with a 180° bend. In another distal tip, the wire within the 180° bend may be in a landscape orientation. In another exemplary distal tip, the loop is formed by a wire having two portions. The two wire portions form an atraumatic tip at a distal most point. As assembled, the wire portions function as a loop in the same way as discussed herein.
Another aspect of the present subject matter is to provide a new shape of the loop. Referring to
It should be understood that some or all of the features described above may be applied to any suitable endoscopic devices or combination of endoscopic devices, such as snare-needle device, a multistage snare, or an endoscopic retrieval device.
A person skilled in the art should understand that although the above-described snare features are designed for cold cutting, they may also be utilized with electrocautery without compromising the features that make them useful for gathering and cutting tissue.
A person skilled in the art should understand that the endoscopic device described in the present subject matter is not necessary to comprise the support assembly (including the base and the elongated tubular member) and/or the transmitting assembly (including the handle and the link). A handle may be formed by or connected to the proximal end of the loop.
While various inventive aspects, concepts and features of the general inventive concepts are described and illustrated herein in the context of various exemplary embodiments, these various aspects, concepts and features may be used in many alternative embodiments, either individually or in various combinations and sub-combinations thereof. Unless expressly excluded herein all such combinations and sub-combinations are intended to be within the scope of the general inventive concepts. Still further, while various alternative embodiments as to the various aspects, concepts and features of the inventions (such as alternative materials, structures, configurations, methods, circuits, devices and components, alternatives as to form, fit and function, and so on) may be described herein, such descriptions are not intended to be a complete or exhaustive list of available alternative embodiments, whether presently known or later developed. Those skilled in the art may readily adopt one or more of the inventive aspects, concepts or features into additional embodiments and uses within the scope of the general inventive concepts even if such embodiments are not expressly disclosed herein. Additionally, even though some features, concepts or aspects of the inventions may be described herein as being a preferred arrangement or method, such description is not intended to suggest that such feature is required or necessary unless expressly so stated. Still further, exemplary or representative values and ranges may be included to assist in understanding the present disclosure; however, such values and ranges are not to be construed in a limiting sense and are intended to be critical values or ranges only if so expressly stated. Moreover, while various aspects, features and concepts may be expressly identified herein as being inventive or forming part of an invention, such identification is not intended to be exclusive, but rather there may be inventive aspects, concepts and features that are fully described herein without being expressly identified as such or as part of a specific invention. Descriptions of exemplary methods or processes are not limited to inclusion of all steps as being required in all cases, nor is the order that the steps are presented to be construed as required or necessary unless expressly so stated.
Claims
1. A tissue removal tool for use with an endoscope, comprising:
- a loop formed by a piece of wire and movable between an open position and a closed position, wherein the loop is defined in the open position by a proximal portion and a distal portion, and wherein portions of the loop are coined;
- a cutting section disposed at least at the distal portion of the loop, wherein the cutting section comprises thinner wire than the proximal portion of the loop;
- a transmitting assembly comprising: a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop portion being movable between the open and closed position by action of the handle.
2. The tissue removal tool of claim 1, wherein both the distal portion and the proximal portion of the loop are coined.
3. The tissue removal tool of claim 2, wherein the proximal portion of the loop is coined in a perpendicular plane to the distal coined portion.
4. The tissue removal tool of claim 1, wherein the wire is bent at a distal end of the distal portion to form a torsion tip.
5. The tissue removal tool of claim 1, wherein the loop is a monofilament loop.
6. The tissue removal tool of claim 1, wherein a widest portion of the loop is more proximal to a proximal end of the loop than a mid-point of the length of the loop is.
7. The tissue removal tool of claim 6, wherein a distance from a mid-point of the length of the loop to the widest portion of the loop is about 3%-45% of the length.
8. The tissue removal tool of claim 7, wherein a distance from the mid-point of the length of the loop to the widest portion of the loop is about 10%-35% of the length.
9. The tissue removal tool of claim 8, wherein the distance from the mid-point of the length of the loop to the widest portion of the loop is about 12%-25% of the length.
10. The tissue removal tool of claim 1 further comprising: a support assembly comprising a base and an elongated tubular member, wherein the handle is movable relative to the base, and the link extends through at least a portion of the tubular member.
11. The tissue removal tool of claim 1, wherein the cutting section covers about ⅓ to ½ of the loop at the distal portion of the loop.
12. The tissue removal tool of claim 1, wherein the cutting section extends about 5 mm to 15 mm from a distal end of the loop in either direction.
13. The tissue removal tool of claim 12, wherein the cutting section extends about 10 mm from a distal end of the loop in either direction.
14. The tissue removal tool of claim 1, wherein the cutting section comprises a diameter of 0.36 mm or thinner.
15. The tissue removal tool of claim 1, wherein the coined portions of the loop are either symmetrical or asymmetrical with respect to the loop centerlines.
16. A tissue removal tool for use with an endoscope, comprising:
- a loop formed by a piece of wire and movable between an open position and a closed position, wherein the loop is defined in the open position by a proximal portion and a distal portion, and wherein portions of the loop are coined;
- a cutting section disposed at least at the distal portion of the loop, wherein the cutting section comprises thinner wire than the proximal portion of the loop;
- a transmitting assembly comprising: a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop portion being movable between the open and closed position by action of the handle; and wherein the cutting section is a cutting element comprising cutting blades disposed on an otherwise non-cutting snare wire.
17. The tissue removal tool of claim 16 further comprising: a support assembly comprising a base and an elongated tubular member, wherein the handle is movable relative to the base, and the link extends through at least a portion of the tubular member.
18. The tissue removal tool of claim 16, wherein both the distal portion and the proximal portion of the loop are coined.
19. The tissue removal tool of claim 16, wherein the proximal portion of the loop is coined in a perpendicular plane to the distal coined portion.
20. The tissue removal tool of claim 16, wherein the wire is bent at a distal end of the distal portion to form a torsion tip.
21. The tissue removal tool of claim 16, wherein the loop is a monofilament loop.
22. The tissue removal tool of claim 16, wherein the cutting section covers about ⅓ to ½ of the loop at the distal portion of the loop.
23. The tissue removal tool of claim 16, wherein the cutting section extends about 5 mm to 15 mm from a distal end of the loop in either direction.
24. The tissue removal tool of claim 23, wherein the cutting section extends about 10 mm from a distal end of the loop in either direction.
25. The tissue removal tool of claim 16, wherein the cutting section comprises a diameter of 0.36 mm or thinner.
26. The tissue removal tool of claim 16, wherein the coined portions of the loop are either symmetrical or asymmetrical with respect to the loop centerlines.
27. A tissue removal tool for use with an endoscope, comprising:
- a loop formed by a piece of wire and movable between an open position and a closed position, wherein the loop is defined in the open position by a proximal portion and a distal portion, and wherein portions of the loop are coined;
- a cutting section disposed at least at the distal portion of the loop, wherein the cutting section comprises thinner wire than the proximal portion of the loop;
- a transmitting assembly comprising: a handle; and a link having a first end attached to the handle and a second end attached to the loop, the loop portion being movable between the open and closed position by action of the handle; and
- wherein the loop comprises an inner loop and an outer loop, wherein the inner loop is secured to the outer loop in at least one location, and the inner loop is thinner than the outer loop.
28. The tissue removal tool of claim 27, wherein the inner loop only covers the distal portion of the loop.
29. The tissue removal tool of claim 27, wherein the inner loop substantially covers the whole loop.
30. The tissue removal tool of claim 27 further comprising: a support assembly comprising a base and an elongated tubular member, wherein the handle is movable relative to the base, and the link extends through at least a portion of the tubular member.
31. The tissue removal tool of claim 27, wherein both the distal portion and the proximal portion of the loop are coined.
32. The tissue removal tool of claim 27, wherein the proximal portion of the loop is coined in a perpendicular plane to the distal coined portion.
33. The tissue removal tool of claim 27, wherein the wire is bent at a distal end of the distal portion to form a torsion tip.
34. The tissue removal tool of claim 27, wherein the loop is a monofilament loop.
35. The tissue removal tool of claim 27, wherein the cutting section covers about ⅓ to ½ of the loop at the distal portion of the loop.
36. The tissue removal tool of claim 27, wherein the cutting section extends about 5 mm to 15 mm from a distal end of the loop in either direction.
37. The tissue removal tool of claim 36, wherein the cutting section extends about 10 mm from a distal end of the loop in either direction.
38. The tissue removal tool of claim 27, wherein the cutting section comprises a diameter of 0.36 mm or thinner.
39. The tissue removal tool of claim 27, wherein the coined portions of the loop are either symmetrical or asymmetrical with respect to the loop centerlines.
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Type: Grant
Filed: Apr 13, 2020
Date of Patent: Mar 7, 2023
Patent Publication Number: 20200237396
Assignee: UNITED STATES ENDOSCOPY GROUP, INC. (Mentor, OH)
Inventors: Alex Uspenski (Chardon, OH), Christopher J. Kaye (Berea, OH), Reza Mohammadpour (Willoughby Hills, OH), Craig Moore (Pepper Pike, OH), Cynthia Ann Ranallo (Eastlake, OH), John Winstanley (Madison, OH)
Primary Examiner: Phong Son H Dang
Application Number: 16/847,274
International Classification: A61B 17/3205 (20060101); A61B 17/00 (20060101); A61B 90/92 (20160101); A61B 17/221 (20060101); A61B 17/32 (20060101);